# Practising for Paediatrics (RCPCH START) with MedMock

Canonical page: https://medmock.com/exams/paediatrics-rcpch-start

## What is the RCPCH START, and how do you practise for it?

The Royal College of Paediatrics and Child Health's Specialty Trainee Assessment of Readiness for Tenure (RCPCH START): a formative multi-station consultant-readiness assessment sat online by ST7 paediatric trainees before CCT. The circuit comprises ten 8-minute stations, each preceded by 4 minutes of preparation time: three Scenario Discussion stations (acute general paediatrics, outpatient and chronic general paediatrics, and subspecialty or complex care) plus seven themed stations — Ward Round and Handover, Safeguarding, Critical Review of a Paper, Safe Prescribing, Ethics and Law, Conflict and Risk, and Teaching. MedMock practises all 10 stations at the real 8-minute station timing with 4 minutes of reading time. MedMock lets you practise it out loud against an AI patient, with examiner-style feedback on any station you finish.

An illustrative example station, written by MedMock with example feedback, is at https://medmock.com/exams/paediatrics-rcpch-start/example

## What happens in the real RCPCH START (checked against the official source on 2026-10-24)

RCPCH START (Specialty Trainee Assessment of Readiness for Tenure) is the Royal College of Paediatrics and Child Health’s formative multi-station assessment for senior paediatric trainees (typically in ST7), evaluating readiness for new-consultant practice. Delivered online in a single circuit, it comprises 10 eight-minute stations, each preceded by four minutes of preparation time. A different consultant paediatrician assessor rates each station across six consultant-readiness domains to generate structured developmental feedback for the trainee’s educational supervisor and ARCP.

- **Scenario Discussion 1 (Acute General Paediatrics)** (8 minutes): Eight-minute consultant-level scenario discussion after four minutes of preparation on an acute general paediatric or neonatal emergency, covering stabilisation, diagnostic reasoning, escalation, retrieval and communication with parents.
- **Scenario Discussion 2 (Outpatient & Chronic General Paediatrics)** (8 minutes): Eight-minute consultant-level scenario discussion after four minutes of preparation on an outpatient or chronic general paediatric problem, covering diagnostic formulation, multidisciplinary care, community interface and transition.
- **Scenario Discussion 3 (Subspecialty & Complex Care)** (8 minutes): Eight-minute consultant-level scenario discussion after four minutes of preparation on a complex multisystem or subspecialty paediatric presentation, shared care across local and tertiary services, and long-term management.
- **Ward Round & Handover** (8 minutes): Eight-minute discussion after four minutes of preparation reviewing a paediatric ward, assessment-unit and neonatal handover list, setting clinical priorities, deploying junior staff safely and managing departmental flow.
- **Safeguarding** (8 minutes): Eight-minute discussion after four minutes of preparation on a consultant child protection scenario, covering clinical assessment, documentation, multi-agency referral, Strategy Discussion and Section 47 processes under Working Together to Safeguard Children.
- **Critical Review of a Paper** (8 minutes): Eight-minute discussion after four minutes of preparation critically appraising a structured paediatric research abstract and explaining whether its findings should change departmental clinical practice.
- **Safe Prescribing** (8 minutes): Eight-minute discussion after four minutes of preparation reviewing a paediatric prescription chart and clinical vignette to identify weight-based dosing, infusion, allergy, interaction or organ-impairment prescribing errors.
- **Ethics & Law** (8 minutes): Eight-minute discussion after four minutes of preparation on a paediatric clinical ethics and law dilemma, including consent, parental responsibility, Gillick competence, treatment refusal and best-interests decision-making.
- **Conflict & Risk** (8 minutes): Eight-minute discussion after four minutes of preparation on consultant clinical governance, patient safety incident response, statutory Duty of Candour, complaints, rota risk or supporting a colleague in difficulty.
- **Teaching** (8 minutes): Eight-minute live teaching station after four minutes of preparation in which the candidate teaches a junior colleague on a focused paediatric topic, checking baseline understanding and confirming learning.

Marking: Each of the 10 stations is assessed by a consultant paediatrician assessor across six RCPCH START domains: decision making and prioritisation; knowledge; management of complexity; professional approach; safety and risk management; and communication. Assessors record structured ratings and written developmental feedback for each station rather than a numerical pass mark.

Passing: RCPCH START is a mandatory formative assessment rather than a high-stakes pass/fail examination. Trainees receive a written feedback report across the 10 stations and six domains, which is reviewed with their educational supervisor to create a targeted personal development plan before CCT and ARCP.

Sources: https://www.rcpch.ac.uk/resources/rcpch-start-about https://www.rcpch.ac.uk/resources/rcpch-start-how-apply https://www.rcpch.ac.uk/resources/rcpch-start-preparing-assessment-day
Full format page: https://medmock.com/exams/paediatrics-rcpch-start/format

## How to prepare for the RCPCH START (facts checked against official sources on 2026-10-24)

RCPCH START is a 10-station formative assessment for ST7 paediatric trainees, with four minutes of preparation before each eight-minute station. Prepare by practising consultant-level decision-making across acute, chronic and complex scenarios, ward-round prioritisation, safeguarding, safe prescribing, critical appraisal, ethics, risk and teaching.

1. **Understand the purpose and timing of RCPCH START** — RCPCH START (Specialty Trainee Assessment of Readiness for Tenure) is taken in ST7 to guide your final stage of training before becoming a consultant paediatrician. The online circuit has 10 eight-minute stations, each preceded by four minutes of preparation time, and generates developmental feedback across six domains for your ARCP.
2. **Use the four-minute preparation window to structure your opening** — Four minutes of reading time lets you organise your thoughts before the assessor joins. In the three Scenario Discussion stations (acute general, outpatient and chronic, and subspecialty and complex care), use the preparation window to separate immediate priorities, differential diagnosis, investigations, multi-agency input and family communication.
3. **Practise Ward Round & Handover and Safe Prescribing systematically** — In Ward Round and Handover, group the handover list by clinical acuity, identify red flags and safeguarding concerns, and delegate tasks clearly across your junior team. In Safe Prescribing, check the child’s age, weight, allergies, renal or hepatic function, drug interactions and BNF for Children dosing rules.
4. **Revise consultant safeguarding, ethics and clinical governance** — Be ready to lead as the attending consultant in Safeguarding (Working Together to Safeguard Children, Strategy Discussions and Section 47 enquiries), Ethics and Law (Gillick competence, parental responsibility, treatment refusal and best-interests decisions) and Conflict and Risk (incident investigation, Duty of Candour and colleagues in difficulty).
5. **Rehearse live teaching and critical appraisal aloud** — In the Teaching station you teach a junior colleague in real time: check their starting understanding, break the topic into clear steps and confirm learning before the eight minutes end. In Critical Review of a Paper, appraise the abstract’s PICO question, methodology, bias and clinical applicability to your department.

Official resources:

- RCPCH START — About the Assessment (https://www.rcpch.ac.uk/resources/rcpch-start-about): Overview of the 10-station RCPCH START circuit, the six assessment domains and how feedback is used at ARCP.
- RCPCH START — Preparing for Assessment Day (https://www.rcpch.ac.uk/resources/rcpch-start-preparing-assessment-day): Official RCPCH guidance on the 10 station types, preparation time and what assessors look for.
- RCPCH START — How to Apply (https://www.rcpch.ac.uk/resources/rcpch-start-how-apply): Eligibility, ST7 application windows, dates and reasonable adjustments for RCPCH START.

Common mistakes examiners report:

- Answering as a middle-grade registrar who escalates to the consultant rather than taking ownership as the new consultant on call. (source: https://www.rcpch.ac.uk/resources/rcpch-start-preparing-assessment-day)
- Delivering a one-way lecture in the Teaching station without checking the learner’s baseline understanding or confirming what they have learned. (source: https://www.rcpch.ac.uk/resources/rcpch-start-preparing-assessment-day)

Sources: https://www.rcpch.ac.uk/resources/rcpch-start-about https://www.rcpch.ac.uk/resources/rcpch-start-how-apply https://www.rcpch.ac.uk/resources/rcpch-start-preparing-assessment-day
Full guide: https://medmock.com/exams/paediatrics-rcpch-start/prepare

Dates: RCPCH START (Specialty Trainee Assessment of Readiness for Tenure) runs online in multiple sittings each year (typically spring and autumn); trainees apply during the RCPCH registration window for their ST7 cohort. (source: RCPCH).
All RCPCH START dates: https://medmock.com/exams/paediatrics-rcpch-start#dates

## Stations you can practise

- **Scenario Discussion 1 (Acute General Paediatrics)** — 8-minute consultant-level scenario discussion after 4 minutes of preparation: acute general paediatric or neonatal presentation, initial stabilisation, diagnostic reasoning, escalation, retrieval and family communication.
- **Scenario Discussion 2 (Outpatient & Chronic General Paediatrics)** — 8-minute consultant-level scenario discussion after 4 minutes of preparation: outpatient or chronic general paediatric presentation, multidisciplinary care, community interface, transition to adult services and long-term management.
- **Scenario Discussion 3 (Subspecialty & Complex Care)** — 8-minute consultant-level scenario discussion after 4 minutes of preparation: complex multisystem or subspecialty paediatric problem, shared care across tertiary and local services, governance and long-term follow-up.
- **Ward Round & Handover** — 8-minute station after 4 minutes of preparation: review a paediatric ward and assessment-unit handover list, prioritise clinical reviews, allocate junior staff safely, identify red flags and structure consultant ward-round leadership.
- **Safeguarding** — 8-minute station after 4 minutes of preparation: consultant-level child protection and safeguarding — Bruising or fractures in a non-mobile infant, fabricated or induced illness, child sexual exploitation, sudden unexpected death in infancy, Strategy Discussion under Working Together to Safeguard Children and Section 47 enquiries.
- **Critical Review of a Paper** — 8-minute station after 4 minutes of preparation: critically appraise a structured paediatric research abstract on screen (PICO, randomisation, blinding, sample size, NNT/CI, bias) and explain whether and how it should change departmental practice.
- **Safe Prescribing** — 8-minute station after 4 minutes of preparation: review an on-screen paediatric prescription chart and clinical scenario, identify weight-based dosing, infusion, interaction, allergy or renal/hepatic adjustment errors, and explain the safe prescription to the examiner.
- **Ethics & Law** — 8-minute station after 4 minutes of preparation: paediatric clinical ethics and law — Gillick competence, Fraser guidelines, parental responsibility (Children Act 1989), refusal of blood products or life-sustaining treatment, Mental Capacity Act 2005 in 16–17-year-olds and best-interests decision-making.
- **Conflict & Risk** — 8-minute station after 4 minutes of preparation: consultant leadership in managing clinical risk, serious incidents, Duty of Candour, complaints, rota gaps, inter-professional disagreement or a colleague in difficulty.
- **Teaching** — 8-minute station after 4 minutes of preparation: teach a junior trainee or allied health professional on a focused clinical topic, checking baseline understanding, structuring the explanation clearly and confirming learning.

## Sample RCPCH START questions

- *Ward Round & Handover:* It is 08:30 on Sunday morning and you are the attending paediatric consultant taking handover of eight patients across the ward, PAU and HDU, with one ST4 and one FY2 on shift. Outline your clinical priorities across the list and explain how you will deploy your team.
- *Safeguarding:* A 4-month-old infant attends the Emergency Department with a spiral humeral fracture and a small frenulum tear; the parents report the baby rolled off the sofa. Discuss your immediate clinical and statutory safeguarding actions as the consultant on call.

## Example scenarios

- *Ward Round & Handover:* It is 08:30 on Sunday morning and you are the attending paediatric consultant taking handover of eight patients across the ward, PAU and HDU, with one ST4 and one FY2 on shift. Prioritise the list and explain how you will deploy your team.
- *Safeguarding:* A 4-month-old infant attends the Emergency Department with a spiral humeral fracture and a small frenulum tear; the parents report the baby rolled off the sofa. Discuss your immediate clinical and statutory safeguarding actions as the consultant on call.
- *Safe Prescribing:* Review the inpatient drug chart for a 14 kg 3-year-old admitted with status epilepticus and febrile neutropenia. Identify the prescribing errors on the chart and state the corrected prescriptions.

## How a practice session works

1. **Choose a station** — Pick from the RCPCH START stations — all 10 that MedMock runs, or let MedMock surprise you the way exam day will.
2. **Have the conversation** — Speak naturally, out loud. The AI patient or examiner responds in real time — with follow-up questions, emotions, cues and unexpected turns, just like the real stations.
3. **Get instant feedback** — The moment you finish, you get specific, examiner-style feedback and a score — what you did well, what cost you marks, and precisely what to fix before the next attempt.

## Price

Start with a one-off £5 taster: 30 credits (30 minutes of speaking practice), not a subscription. After that, or instead, £119 per month for 600 credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Cancel at any time. Full details: https://medmock.com/pricing

## Frequently asked questions

### How does the feedback work?

When you finish a station you can have it marked, and the scorecard comes back in seconds — what you did well, what cost you marks, and exactly what to work on next. Scorecards, mark schemes and model answers are included at no extra credit cost.

### Can I practise specific RCPCH START stations?

Yes. You can pick any of the 10 stations to drill a weak area, or run a mixed set to simulate the real exam.

### How much does it cost?

You can start with a one-off £5 taster: 30 credits, which is 30 minutes of speaking practice, with no subscription. After that, or at any time, you can choose a monthly plan, which includes a monthly credit allowance. Current prices are on the pricing page.

## About MedMock

MedMock is a web app for practising the spoken parts of UK medical and dental exams and interviews out loud. The candidate talks; an AI patient, examiner or interview panel answers in real time by voice; and when the station ends MedMock marks the performance against that exam's assessment domains and shows the model answer.

It covers 104 spoken exams and interviews — OSCEs, vivas, structured oral exams, simulated consultations, and specialty-training and consultant interviews. It does not cover written or multiple-choice papers, and it is not a question bank.

It was founded by Mr Sam Nahas, MBBS BSc MEd FRCS (Tr & Orth), a practising consultant orthopaedic surgeon in the UK, with co-founder and CTO Arjan Jandu. It is operated by VirtualPatients Ltd (company no. 16303492).

Pricing: a one-off £5 taster of 30 credits to try it (not a subscription, one per account), and a monthly subscription from £20 to £129 depending on the exam (student exams cost least, fellowship exit exams and consultant interviews most), or £199 to £275 for the Intensive plans, which carry more credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Subscriptions can be cancelled at any time.

It runs in a web browser on a laptop or phone; spoken practice needs a microphone. There is no public demo: practice needs an account with credits, usually from the taster or a monthly plan.

MedMock is for adults aged 18 or over. Sign-up asks every new account to confirm it.

MedMock is a revision tool. The patients, examiners and cases are fictional and AI-generated; it is not clinical guidance and is not affiliated with or endorsed by any Royal College, the GMC, the GDC or any examining body.

Start with the £5 taster: https://medmock.com/auth/signup